Rep. Darby hosts MHMR town hall

Legislator hears which programs work, struggle

SAN ANGELO, Texas - State Rep. Drew Darby remembered getting a visit during the most recent Texas Legislative session from disabled residents of a home receiving state support. That legislative session saw intensive budgeting cuts to handle an initial shortfall of $27 billion.

About 30 people from the community met in a committee room. Darby said he looked out at them from his podium, and a little girl raised her hand.

"I called on her, and she said, 'Mr. Darby, are you going to close my home?' " Darby said. "I got to tell you, tears came to my eyes."

The state didn't close her home in the end, Darby said.

Needs ran deep in the health care town hall meeting that San Angelo's state representative Darby hosted Wednesday, where he told that story.

About 50 health care authorities came from across West Texas for the afternoon, gathering at the MHMR Services for the Concho Valley administrative offices.

They spoke on the increasing caseload of mental health deputies, the need for room at facilities so mentally disabled people can move out of jail, help with rates in indigent detox centers, help to cut bureaucracy connect medical care, and staying away from cuts.

"It's up to the people in this room to put faces on what it means to cut services," Darby said.

Pleas came out to get funds to help enhance services in the region, especially regarding mental health. Darby said more funds may not always be the answer, but he said he liked cutting down poor laws that might hinder health care services.

The coming legislative session, which convenes Jan. 8, will have a heftier budget than before, but the state will still need to make deferred payments to Medicaid and school funding, Darby said. He said the Legislature had decided to make the payments later in hopes Texas would recover economically, and it has, he said.

"Our revenue side is looking brighter and brighter," Darby said.

health care reform

With the Patient Protection and Affordable Care Act in place, President Barack Obama's signature health care law, Darby said the state is leaning away from setting up health care markets as mandated.

The state has the option of setting up the markets, or "exchanges," where people can easily shop for health care. If the state doesn't participate, then the federal government would set up the exchanges, although the state can enter into the process at any time, Darby said.

The state will probably also not participate in the expansion of Medicaid, Darby said.

The federal government offered to pay the full cost of Medicaid for up to three years and then decrease to 90 percent in later years if the state expands Medicaid to those at up to 133 percent of the federal poverty line.

The Kaiser Family Foundation, a health care analysis organization, released information in November that said "state Medicaid spending nationally would rise by $76 billion from 2013 to 2022, an increase of less than 3 percent, while federal Medicaid spending would increase by $952 billion, or 26 percent" if all of the states expanded their programs.

According to the foundation report, over a period of 10 years, Texas would spend $5.67 billion more on Medicaid than it would if it did without expanding the program.

Darby said lawmakers don't trust the federal government to pay out.

"I'm not willing as a legislator to take the federal government's check right now," Darby said. "We've seen them make promises. Our greatest concern is we enroll in that program and then they don't pay."

The state also wants flexibility in grants and funding, Darby said.

Mental health deputies

Those gathered praised the Tom Green County Sheriff Office's Mental Health Unit and asked to get more resources for the program.

Deputies in the program specialize in cases where mental health is concerned, stepping in, for example, when a person becomes suicidal.

"We're serving about 140-160 people per month," Tom Green County Sheriff-elect David Jones said. "It's huge. ... We're preventing suicides, we're preventing a lot of problems. It has helped our jail situation tremendously. We still have a problem in our jails with people needing to be evaluated."

San Angelo Police Chief Tim Vasquez said San Angelo is rich in partnerships that help make the program happen.

"I think we are a poster child for the state," Vasquez said of the mental health deputy program.

Tom Green County Treasurer Dianna Spieker, who also oversees the county's indigent health care program, said the program is good, but more state money would help hire more people and send them to training.

Precinct 4 Justice of the Peace Eddie Howard said the mental health deputy program began with the idea of taking 350 calls per year; now they're doing 140-160 per month.

State health care providers for people with mental disabilities are running out of beds because of the load of forensic cases. Forensic cases involve people with mental health issues who are involved in criminal court cases. A district court case in Travis County is mandating that the state has 21 days to get people with mental health issues out of jails when they've been found not competent to stand trial and need treatment.

Because of the need to move people out of jail and into other mental health facilities, there is less room for people who need help locally but are not forensic.

"The need is far greater than the amount that we have," said Lynn Rutland, the executive director for MHMR Services for the Concho Valley, about the need for services.

Darby said the state may be able to pursue resources to obtain more room, or the issue may fall to partnerships with community members, such as those between MHMR Services for the Concho Valley and Shannon Medical Center and Rivercrest Hospital already in existence.

More state funds can help those local partnerships, Rutland said.

Detox

The Alcohol and Drug Abuse Council of the Concho Valley said it is struggling to support its detoxification programs.

Rates from the state are low, around $75-$79 per day, said Eric Sanchez ADACCV CEO. He said he was given more than $100 for a stay in Austin on business.

"They pay me more to stay at a hotel when I go to Austin for a meeting than they do for us providing intense residential treatment," Sanchez said. "Something has got to be done about that."

ADACCV makes ends meet through donations in the region, Sanchez said.

Darby said he would work with matters such as by decreasing bureaucracy.

Lettitia McPherson, the executive director of The Arc of San Angelo, which aims to help people with developmental or intellectual disabilities, said the increased bureaucracy weighs on the organization. Increased numbers of audits, for example, can hinder the organization, she said.

Attendees at the meeting voiced hope for no cuts, as well.

"There should be more funds in this budget cycle," Darby said. "But I see the needs continue to escalate."